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. 2023 Jun;75(2):835-841.
doi: 10.1007/s12070-023-03528-4. Epub 2023 Feb 5.

A Prospective Institutional Study on Aetiopathogenesis, Management and Complications of Laryngotracheal Stenosis

Sourabh Padmanabhan  1 , Ranganath Swamy  1 , Shobhan Babu  1 , Y Mounika Reddy  1 , Naresh Mogilicharla  1
Affiliations

A Prospective Institutional Study on Aetiopathogenesis, Management and Complications of Laryngotracheal Stenosis

Sourabh Padmanabhan et al. Indian J Otolaryngol Head Neck Surg. 2023 Jun.

Abstract

The main purpose of this study is to evaluate and understand the clinical profile of patients presenting to an Indian tertiary care referral centre with Laryngotracheal Stenosis (LTS) and also to emphasise on the outcomes after treatment in these patients. This is a prospective observational study conducted at a tertiary care referral centre which included 18 patients diagnosed with LTS. All patients were evaluated clinically and radiologically to evaluate the degree of stenosis, site and length of the stenotic segment involved, intervened surgical procedure, intraoperative and postoperative complications following the procedure were all documented and taken into consideration. The data collected was analysed. The most common etiological cause of LTS was post intubation (77.8%). 61.5% among the 13 intubated patients had a history of intubation for more than 10 days. 83.3% of the cases had stenosis at the level of the subglottis and cervical trachea level. Post intubational airway stenosis is the most common cause of LTS. A precise assessment of the laryngotracheal complex is the cornerstone of LTS management. The choice of treatment depends on the location, severity, and length of stenosis, as well as on the patient's comorbidities, history of previous interventions, and on the expertise of the surgical team. Application of topical Mitomycin c during surgery reduces the incidence of granulations. Close postoperative follow up for a long time and the necessity of more than one intervention improves results and can spare patients the morbidity and mortality associated with acute airway obstruction.

Keywords: Cricotracheal resection; Dumon stent; Laryngotracheal stenosis; Mitomycin C; Montgomery T tube; Postintubation.

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Conflict of interest statement

Conflict interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
A Computed tomography image of the neck, sagittal view showing Laryngotracheal stenosis. B Preoperative videolaryngoscopic Image showing grade 4 Cotton Meyers subglottic stenosis. C–F showing management of LTS via anterior cricoid split and coastal cartilage grafting.
Fig. 2
Fig. 2
A Computed tomography image of the neck, sagittal view showing Laryngotracheal stenosis. B–D showing partial tracheal resection with Dumons stenting and aural cartilage grafting. E Computed tomography image of the neck, coronal view showing Laryngotracheal stenosis. F, G showing management of LTS with excision of the stenotic segment, followed by Montgomery T tube placement with aural cartilage grafting and H postoperative image with Montgomery T tube in situ
Fig. 3
Fig. 3
Distribution of cases based on the degree of airway narrowing according to Cotton Meyer Classification
See this image and copyright information in PMC

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